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148 条记录 (耗时 0.058 秒)

    Electrosurgical systems and methods for the removal of pacemaker leads
    41.
    发明授权
    Electrosurgical systems and methods for the removal of pacemaker leads 失效
    用于去除起搏器导线的电外科系统和方法

    公开(公告)号：US06183469B2

    公开(公告)日：2001-02-06

    申请号：US09002315

    申请日：1998-01-02

    申请人： Hira V. Thapliyal ,  Philip E. Eggers ,  Katherine M. Williams ,  Michael A. Baker ,  Phillip M. Olsen

    发明人： Hira V. Thapliyal ,  Philip E. Eggers ,  Katherine M. Williams ,  Michael A. Baker ,  Phillip M. Olsen

    IPC分类号： A61B1814

    CPC分类号： A61B18/1206 ,  A61B18/1233 ,  A61B18/1485 ,  A61B18/1492 ,  A61B2017/003 ,  A61B2017/22038 ,  A61B2018/00214 ,  A61B2018/0041 ,  A61B2018/00422 ,  A61B2018/00577 ,  A61B2018/00583 ,  A61B2018/00702 ,  A61B2018/00827 ,  A61B2018/1213 ,  A61B2018/1253 ,  A61B2018/1273 ,  A61B2018/1467 ,  A61B2018/1472 ,  A61B2018/162 ,  A61B2218/002 ,  A61B2218/007 ,  A61B2218/008

    摘要： The present invention is directed to systems, methods and apparatus for removing implanted objects from a patient's body, particularly implanted endocardial or epicardial pacemaker leads and transvenous defibrillation leads from a patient's heart. In one aspect of the invention, an electrosurgical catheter is advanced to a position within the thoracic cavity adjacent a portion of a pacemaker lead that is affixed to heart tissue. Preferably, the catheter is advanced over the pacemaker lead, i.e., using the pacemaker lead as a guidewire, to facilitate this positioning step. Once the distal end of the catheter reaches a blockage, or a portion of the lead that is attached to fibrous scar tissue, a high frequency voltage difference is applied between one or more electrode terminal(s) at the distal end of the catheter and one or more return electrode(s) to remove the scar tissue around the lead. The catheter is then advanced further along the lead until it reaches another blockage caused by fibrous scar tissue, and the process is continued until the catheter reaches the distal tip of the lead in the myocardium. At this point, the distal tip may be severed from the rest of the lead, or pulled out of the myocardial tissue in a conventional manner. The scar tissue around the pacemaker lead is precisely ablated before removing the lead, which minimizes or eliminates the risks associated with mechanical traction and countertraction, such as disruption of the heart wall, lead breakage with subsequent migration and the like.

    摘要翻译： 本发明涉及用于从患者体内去除植入物体的系统，方法和装置，特别是植入心内膜或心外膜起搏器引线和来自患者心脏的经静脉除颤引线。 在本发明的一个方面，电外科导管被推进到靠近与心脏组织固定的起搏器引线的一部分相邻的胸腔内的位置。 优选地，导管在起搏器引线上前进，即使用起搏器引线作为导丝，以便于该定位步骤。 一旦导管的远端到达阻塞或者连接到纤维性瘢痕组织的引线的一部分，则在导管远端的一个或多个电极端子和一个或多个电极端子之间施加高频电压差 或更多的返回电极以去除铅周围的瘢痕组织。 然后导管沿着引线进一步前进，直到达到由纤维性瘢痕组织引起的另一个阻塞，并且继续该过程直到导管到达心肌中的引线的远端。 在这一点上，远端尖端可以从导线的其余部分切断，或以常规方式从心肌组织拉出。 在除去铅之前，起搏器引线周围的瘢痕组织被精确地消融，这使得最小化或消除与机械牵引和反向相关的风险，例如心脏壁的破坏，随后的迁移等引起的断裂。

    Electrosurgical method for the removal of pacemaker leads
    42.
    发明授权
    Electrosurgical method for the removal of pacemaker leads 有权
    电除去起搏器导线的电外科手术

    公开(公告)号：US06379351B1

    公开(公告)日：2002-04-30

    申请号：US09507366

    申请日：2000-02-18

    申请人： Hira V. Thapliyal ,  Philip E. Eggers ,  Katherine M. Williams ,  Michael A. Baker ,  Phillip M. Olsen

    发明人： Hira V. Thapliyal ,  Philip E. Eggers ,  Katherine M. Williams ,  Michael A. Baker ,  Phillip M. Olsen

    IPC分类号： A61B1814

    CPC分类号： A61B18/1206 ,  A61B18/1233 ,  A61B18/1485 ,  A61B18/1492 ,  A61B2017/003 ,  A61B2017/22038 ,  A61B2018/00214 ,  A61B2018/0041 ,  A61B2018/00422 ,  A61B2018/00577 ,  A61B2018/00583 ,  A61B2018/00702 ,  A61B2018/00827 ,  A61B2018/1213 ,  A61B2018/1253 ,  A61B2018/1273 ,  A61B2018/1467 ,  A61B2018/1472 ,  A61B2018/162 ,  A61B2218/002 ,  A61B2218/007 ,  A61B2218/008

    摘要： The present invention is directed to systems, methods and apparatus for removing implanted objects from a patient's body, particularly implanted endocardial or epicardial pacemaker leads and transvenous defibrillation leads from a patient's heart. In one aspect of the invention, an electrosurgical catheter is advanced to a position within the thoracic cavity adjacent a portion of a pacemaker lead that is affixed to heart tissue. Preferably, the catheter is advanced over the pacemaker lead, i.e., using the pacemaker lead as a guidewire, to facilitate this positioning step. Once the distal end of the catheter reaches a blockage, or a portion of the lead that is attached to fibrous scar tissue, a high frequency voltage difference is applied between one or more electrode terminal(s) at the distal end of the catheter and one or more return electrode(s) to remove the scar tissue around the lead. The catheter is then advanced further along the lead until it reaches another blockage caused by fibrous scar tissue, and the process is continued until the catheter reaches the distal tip of the lead in the myocardium. At this point, the distal tip may be severed from the rest of the lead, or pulled out of the myocardial tissue in a conventional manner. The scar tissue around the pacemaker lead is precisely ablated before removing the lead, which minimizes or eliminates the risks associated with mechanical traction and countertraction, such as disruption of the heart wall, lead breakage with subsequent migration and the like.

    摘要翻译： 本发明涉及用于从患者体内去除植入物体的系统，方法和装置，特别是植入心内膜或心外膜起搏器引线和来自患者心脏的经静脉除颤引线。 在本发明的一个方面，电外科导管被推进到靠近与心脏组织固定的起搏器引线的一部分相邻的胸腔内的位置。 优选地，导管在起搏器引线上前进，即使用起搏器引线作为导丝，以便于该定位步骤。 一旦导管的远端到达阻塞或者连接到纤维性瘢痕组织的引线的一部分，则在导管远端的一个或多个电极端子和一个或多个电极端子之间施加高频电压差 或更多的返回电极以去除铅周围的瘢痕组织。 然后导管沿着引线进一步前进，直到达到由纤维性瘢痕组织引起的另一个阻塞，并且继续该过程直到导管到达心肌中的引线的远端。 在这一点上，远端尖端可以从导线的其余部分切断，或以常规方式从心肌组织拉出。 在除去铅之前，起搏器引线周围的瘢痕组织被精确地消融，这使得最小化或消除与机械牵引和反向相关的风险，例如心脏壁的破坏，随后的迁移等引起的断裂。